EP3629946B1 - Dispositif de coupe ultrasonique pour ostéotomie - Google Patents

Dispositif de coupe ultrasonique pour ostéotomie Download PDF

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Publication number
EP3629946B1
EP3629946B1 EP18730871.3A EP18730871A EP3629946B1 EP 3629946 B1 EP3629946 B1 EP 3629946B1 EP 18730871 A EP18730871 A EP 18730871A EP 3629946 B1 EP3629946 B1 EP 3629946B1
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EP
European Patent Office
Prior art keywords
blade
cutting device
ultrasonic cutting
teeth
longitudinal axis
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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Application number
EP18730871.3A
Other languages
German (de)
English (en)
Other versions
EP3629946A1 (fr
Inventor
Elisa STABILINI
Andrea CHIRICO
Nicol CERISOLA
Giorgio BOZZINI
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
MECTRON SpA
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MECTRON SpA
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Publication date
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/14—Surgical saws ; Accessories therefor
    • A61B17/142—Surgical saws ; Accessories therefor with reciprocating saw blades, e.g. with cutting edges at the distal end of the saw blades
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320072—Working tips with special features, e.g. extending parts
    • A61B2017/320074—Working tips with special features, e.g. extending parts blade
    • A61B2017/320075—Working tips with special features, e.g. extending parts blade single edge blade, e.g. for cutting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320072—Working tips with special features, e.g. extending parts
    • A61B2017/320074—Working tips with special features, e.g. extending parts blade
    • A61B2017/320077—Working tips with special features, e.g. extending parts blade double edge blade, e.g. reciprocating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320084—Irrigation sleeves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00565—Bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting

Definitions

  • the present invention relates generally to the field of osteotomy cutting devices. More particularly, the invention relates to a minimally invasive blade cutting device for ultrasound osteotomy.
  • ultrasound devices are extremely common, which include a vibration generator with an ultrasonic frequency, typically of the order of a few tens of kHz, for example 20 kHz or higher, to which an appropriately shaped blade can be connected through a special attachment and an extension.
  • Known ultrasonic cutting devices comprise a flat blade which develops in a longitudinal direction and is shaped like a hacksaw or a chisel.
  • the vibration generator is configured to generate longitudinal vibrations, parallel to the blade development direction, which favour the cutting action with reciprocating movement exerted manually by a surgeon.
  • ultrasonic cutting devices are preferred over that of traditional, manual or motorized cutting devices, because the ultrasonic vibrations favour the penetration of the blade reducing the force required by a surgeon, which allows greater precision in making a cut.
  • Ultrasonic cutting devices can be improved as regards the blade guide and penetration features, both considering the increasingly felt need for a high cutting precision, and the fact that the blade must generally cut through bone tissues of varying consistency and thickness without damaging the underlying organs and/or tissues, especially in the case of spinal and cranial surgery, in which damage to the dura mater should be minimized.
  • the technical problem posed and solved by the present invention is therefore that of providing an improved ultrasonic cutting device which allows overcoming the drawbacks mentioned above with reference to the prior art.
  • the ultrasonic cutting device for osteotomy comprises a blade and an attachment member configured to be connected to a longitudinal vibration generator.
  • the blade comprises a proximal portion connected to the attachment member and a distal portion which carries a plurality of cutting elements.
  • Such cutting elements comprise a portion of arcuate shape obtained at the free end of the blade in the longitudinal direction and on which there is a continuous cutting profile.
  • the cutting elements further comprise a plurality of teeth obtained on both sides of the blade symmetrically with respect to a longitudinal axis thereof. The teeth are aligned with each other along incident directions with respect to the longitudinal axis of the blade, so that the overall configuration of the distal portion is that of a wedge which widens from the arcuate portion in the proximal direction.
  • the main advantage provided by the invention is that of combining a continuous cutting profile with a pair of discontinuous cutting profiles respectively consisting of a plurality of teeth, in which each cutting profile has a specific function.
  • the continuous cutting profile obtained at the free end in the longitudinal direction serves for guiding the device during the initial penetration step in the bone tissue, and offers a surgeon a good tactile feedback due to the continuous contact between the latter and the blade.
  • the teeth arranged in alignment along directions which are incident with respect to the longitudinal axis of the blade allow instead to progressively widen the slit produced initially in the bone by the arcuate portion, without requiring a surgeon to move the blade sideways.
  • the one according to the invention allows a surgeon to concentrate more on the precision of the cut and its depth, being able to rely on a blade geometry which autonomously provides for widening the produced slit, as the cutting device is advanced into the bone tissue.
  • the cutting profile of the arcuate portion is formed as a chamfer in the thickness direction of the blade, which simplifies manufacture in particular considering the dimensions and millimetric thicknesses of the blades of the ultrasonic cutting devices for osteotomy.
  • the ultrasonic cutting device comprises a plurality of indentations formed in the longitudinal direction in the vicinity of the arcuate portion.
  • the function of the indentations is to improve the effect of frontal penetration of the device.
  • an ultrasonic cutting device according to the invention is generally indicated with reference numeral 100.
  • the device 100 comprises a blade 110 which extends in a longitudinal direction L from an attachment member or tang 120 of the device 100 itself configured for connection to a handpiece (not shown) provided with a generator of ultrasonic vibrations directed predominantly in the longitudinal direction L.
  • the connection between the device 100 and the handpiece is not direct, but is carried out through a special rod-like extension (not shown) suitably protected from contact with the tissues by means of a sheath.
  • the blade 110 has a generally flat shape and the attachment member 120, of generally cylindrical shape, is connected to the blade 110 at a proximal portion 111 thereof, of thickness gradually decreasing in the longitudinal direction L.
  • the blade 110 and the attachment member 120 are made in one piece and made of stainless steel for medical use, for example X40CrMoVN16-2.
  • the blade 110 further comprises a distal portion provided with a plurality of cutting elements, as will be described in detail hereinafter.
  • the distal portion is indicated as a whole with reference numeral 112.
  • the longitudinal sides or edges of the blade 110 are generally rectilinear and respectively parallel to a longitudinal axis A of the blade 110, which is in turn parallel to the longitudinal direction L.
  • connection between the device 100 and the extension member can be of threaded type and for this purpose in the connection 120, for example, a threaded hole 121 is made, for example, in the longitudinal direction.
  • a threaded hole 121 is made, for example, in the longitudinal direction.
  • on its outer surface there are for example at least two diametrically opposed flat surfaces 122 for manoeuvring.
  • the attachment member 120 further comprises a channel 123 which extends in the longitudinal direction L from the hole 121 towards the proximal portion 111 of the blade 110 and flows at an irrigation aperture 124 through which is possible to deliver a refrigerant fluid, for example a saline solution, provided by a remote supply source (not shown) connected to the handpiece.
  • a refrigerant fluid for example a saline solution
  • the blade 110 of the ultrasonic cutting device 100 is placed in the vicinity of the part to be cut without touching any surface.
  • the vibration generator and the supply source of the refrigerant fluid are then started, and subsequently the blade 110 is brought into contact with the reference bone surface in the surgical site.
  • the blade 110 is moved alternately back and forth in the longitudinal direction L with respect to the bone tissue progressively penetrating therein.
  • the refrigerant fluid delivered by the irrigation aperture 124 allows the removal of heat from the surgical site, favouring the penetration of the blade 110.
  • the distal portion 112 of the blade 110 comprises an arcuate portion 113 formed at the free end in the longitudinal direction L.
  • the arcuate portion 113 develops symmetrically with respect to the longitudinal axis A of the blade 110, for example over an arc of about 180°.
  • the arcuate portion 113 comprises a continuous cutting profile 114 formed for example as a bevel in the thickness direction of the blade 110, as shown in the longitudinal section in figure 3 .
  • the inclination angle ⁇ of the chamfer is preferably comprised between 30° and 45°.
  • the continuous cutting profile 114 of the arcuate portion 113 allows obtaining a high blade guiding precision during the execution of a cut and offers a surgeon a good tactile feedback due to the continuous contact between the blade 110 and the bone tissue.
  • the arcuate portion 113 further comprises at its opposite ends two edges 115, 116 which join to the sides of first teeth 117, 118 of respective sets of teeth, all equal to each other, formed on both sides of the blade 110.
  • the teeth 117, 118 each have an isosceles triangular plan view and are preferably longitudinally spaced from each other by respective grooves which facilitate the discharge of the fragments of bone material during the cut.
  • the teeth 117, 118 formed on each side of the blade 110 are aligned with each other along incident directions with respect to the longitudinal axis A, schematically shown by broken lines.
  • the inclination angle ⁇ of such incident directions is preferably comprised between 5° and 10°.
  • the overall plan configuration of the distal portion 112 is symmetrical with respect to the longitudinal axis A and, in the section where the teeth 117, 118 are formed, progressively widens from the arcuate portion 113 towards the proximal portion 111 of the blade 110.
  • the distal portion 112 terminates beyond the teeth 117, 118, where the blade 110 has a smaller width and a rectangular plan shape.
  • the conformation of the distal portion 112 causes a gradual widening of the slit created by the blade 110, which allows a surgeon to concentrate more on the cutting direction and its depth to the benefit of precision of execution of the same cuts.
  • this particular configuration of the distal portion 112 contributes to the elimination of the bone material removed in synergy with a transversal component of the vibratory movement, or perpendicular to the longitudinal direction L and to the axis A of the ultrasonic device 100.
  • the ultrasonic cutting device 100 comprises a plurality of indentations formed in the distal portion.
  • the indentations are formed in the distal portion 112 of the blade 110 in the area surrounded by the arcuate portion 113 and extend parallel to the longitudinal axis A up to the chamfer 114.
  • the function of the indentations is to facilitate the penetration of the device 100 into the bone tissue. More particularly, the portions of bone tissue located at the grooves of the indentations are removed from the transverse component of the vibratory motion transmitted to the ultrasonic device 100, thus facilitating penetration into the bone tissue. In other words, the indentations allow "removing" the bone material by freeing the space for the advancement of the device 100.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biomedical Technology (AREA)
  • Dentistry (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Mechanical Engineering (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Surgical Instruments (AREA)

Claims (9)

  1. Dispositif de coupe par ultrasons (100) pour ostéotomie, ledit dispositif comprenant :
    - une lame (110) s'étendant selon une direction longitudinale (L) ;
    - un élément de fixation (120) configuré pour être connecté, par l'intermédiaire d'un élément d'extension approprié, à une pièce à main configurée pour générer des vibrations principalement dirigées dans ladite direction longitudinale (L), ledit élément de fixation (120) étant connecté à l'extrémité proximale (111) de ladite lame (110) ;
    dans lequel la lame (110) comprend en outre une pluralité d'éléments de coupe formés sur sa partie distale (112),
    dans lequel lesdits éléments de coupe comprennent:
    - une partie courbe (113) agencée sur une extrémité libre de ladite partie distale (112) dans la direction longitudinale (L), ladite partie courbe (113) ayant un bord de coupe continu (114) ;
    - une pluralité de dents (117, 118) ayant une forme triangulaire, lesdites dents (117, 118) étant formées sur les côtés opposés de la lame (110) de façon symétrique par rapport à un axe longitudinal (A) de celle-ci, les dents (117, 118) étant alignées les unes avec les autres respectivement le long de directions qui coupent ledit axe longitudinal (A),
    la configuration globale de la partie distale (112) de la lame (110) étant symétrique par rapport à l'axe longitudinal (A) et s'élargissant progressivement à partir de la partie courbe (113) vers la partie proximale (111) de la lame (110) dans la partie où sont formées les dents (117, 118).
  2. Dispositif de coupe par ultrasons (100) selon la revendication 1, dans lequel la partie courbe (113) s'étend sur un arc d'environ 180° de façon symétrique par rapport à l'axe longitudinal (A).
  3. Dispositif de coupe par ultrasons (100) selon l'une des revendications 1 et 2, dans lequel le bord de coupe continu (114) de la partie courbe (113) est un chanfrein formé selon la direction de l'épaisseur de la lame (110).
  4. Dispositif de coupe par ultrasons (100) selon la revendication 3, dans lequel un angle d'inclinaison (β) dudit chanfrein est compris entre 30° et 45°.
  5. Dispositif de coupe par ultrasons (100) selon l'une quelconque des revendications 1 à 4, comprenant en outre une pluralité d'indentations formées dans la partie distale (112) de la lame (110) entourée par la partie courbe (113), lesdites indentations s'étendant parallèlement à l'axe longitudinal (A) jusqu'au chanfrein (114).
  6. Dispositif de coupe par ultrasons (100) selon l'une quelconque des revendications 1 à 5, dans lequel, selon une vue en plan de dessus, chaque dent (117, 118) a la forme d'un triangle isocèle.
  7. Dispositif de coupe par ultrasons (100) selon la revendication 6, dans lequel les dents (117, 118) sont espacées longitudinalement les unes des autres respectivement par des rainures.
  8. Dispositif de coupe par ultrasons (100) selon l'une quelconque des revendications 1 à 7, dans lequel les directions le long desquelles sont alignées les dents (117, 118) sont inclinées par rapport à l'axe longitudinal (A) selon un angle d'inclinaison (α) compris entre 5° et 10°.
  9. Dispositif de coupe par ultrasons (100) selon l'une quelconque des revendications 1 à 8, dans lequel l'élément de fixation (120) comprend un canal (123) pour l'alimentation en un fluide réfrigérant et une ouverture d'irrigation (124) pour distribuer ledit fluide, ladite ouverture d'irrigation (124) étant formée à proximité de la partie proximale (111) de la lame (110).
EP18730871.3A 2017-05-31 2018-05-29 Dispositif de coupe ultrasonique pour ostéotomie Active EP3629946B1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IT102017000059460A IT201700059460A1 (it) 2017-05-31 2017-05-31 Dispositivo ultrasonico di taglio per osteotomia
PCT/IB2018/053791 WO2018220515A1 (fr) 2017-05-31 2018-05-29 Dispositif de coupe ultrasonique pour ostéotomie

Publications (2)

Publication Number Publication Date
EP3629946A1 EP3629946A1 (fr) 2020-04-08
EP3629946B1 true EP3629946B1 (fr) 2021-06-30

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EP18730871.3A Active EP3629946B1 (fr) 2017-05-31 2018-05-29 Dispositif de coupe ultrasonique pour ostéotomie

Country Status (4)

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US (1) US20200178999A1 (fr)
EP (1) EP3629946B1 (fr)
IT (1) IT201700059460A1 (fr)
WO (1) WO2018220515A1 (fr)

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20220304701A1 (en) * 2019-07-01 2022-09-29 Fusion Orthopedics, Llc Surgical instruments including a set of cutting burrs for performing an osteotomy
CN110313972A (zh) * 2019-07-31 2019-10-11 北京水木天蓬医疗技术有限公司 超声骨刀刀头及使用该刀头的机器人辅助超声骨动力系统
EP4153366A1 (fr) 2020-05-18 2023-03-29 Bosonic AG Outil à ultrasons et procédé de fabrication de l'outil
CN114431922A (zh) * 2022-01-27 2022-05-06 以诺康医疗科技（苏州）有限公司 超声刀刀头

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CA2042006C (fr) * 1990-05-11 1995-08-29 Morito Idemoto Corne a ultrasons pour interventions chirurgicales
US5695510A (en) * 1992-02-20 1997-12-09 Hood; Larry L. Ultrasonic knife
US20040023187A1 (en) * 2002-08-02 2004-02-05 Hickok Teresa R. Ultrasonic surgical dental tool and method of making same
EP2374428A1 (fr) * 2010-04-12 2011-10-12 CetaTech, Inc. Technological Innovation Center for Mechanical parts of Automobiles Extrémité ultrasonique médicale et dentaire et son procédé de fabrication

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
None *

Also Published As

Publication number Publication date
EP3629946A1 (fr) 2020-04-08
WO2018220515A1 (fr) 2018-12-06
IT201700059460A1 (it) 2018-12-01
US20200178999A1 (en) 2020-06-11

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